Title: An Investigation and Management of Outbreak of Hepatitis E in South-Western India

Authors: R K Singh, Vikas Raj, Richa Ranjan, Rigvardhan, Mukul Bajpai

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i9.14

Abstract

Background: The term viral hepatitis is reserved for infections of liver caused by a group of viruses having a particular affinity for the liver. A study was carried out to determine the etiological diagnosis, clinical profile, and management outcome in an epidemic of viral hepatitis.

Methods: Cases of acute viral hepatitis (n=64) admitted in this hospital were included in the study. Controls who were apparently healthy (n=30) were also evaluated to know the incidence of sub clinical infection. Clinical profile, liver function tests and serological tests were utilized for diagnosis. Management was conservative.

Results: Of the 64 cases under study 59 (92.1%) were positive for IgM HEV while 03 out of 30 (10%) controls were positive for IgM HEV. Most of the patients presented with anorexia, jaundice, pain abdomen, and deranged liver function tests. Clinical outcomes were satisfactory in all cases with no deaths or any serious complications.

Conclusion: Hepatitis E is common cause for outbreak of epidemic in closed community. A methodical and systemic approach along with high index of suspicion leads to early diagnosis and a concerted approach by medical and administrative authorities helps in containing the epidemic and prevention of complications and fatality.

Keywords: Viral hepatitis E, Deranged LFT, IgM HEV.

References

1.      Bryan JP, Mohammad I et al. Epidemic of hepatitis E in a military unit in Abbottabad, Pakistan. Am. J. Trop. Med. Hyg 2002; 67(6): 662–8.

2.      Buisson Y, Coursaget P, Bercion R, Anne D, Debord T, Roue R. Hepatitis E virus infection in soldiers sent to endemic regions. Lancet 1994; 344: 1165–6.

3.      Coursaget P, Buisson Y, Enogat N, Bercion R, Baudet JM, Delmaire P, Prigent D, Desrame J. Outbreak of enterically transmitted hepatitis due to hepatitis A and hepatitis E viruses. J Hepatol 1998; 28: 745–50.

4.      Tsega E, Krqwczynski T, Hansson BG, Nordenfelt E, Negusse Y, Alemu W, Bahru Y. Outbreak of acute hepatitis E virus infection among military personnel in northern Ethiopia. J Med Virol 1991;34: 232–6.

5.      Sarguna P, Rao A, Sudharamana KN. Outbreak of acute viral hepatitis due to hepatitis E virus in Hyderabad. Indian Journal of Medical Microbiology 2007;25: 378-82

6.      Mishra B, Srinivasa H, Muralidharan S, Charles S, Macaden RS. Hospital based study of Hepatitis E by serology Department of Microbiology, St. John's Medical College, Bangalore - 560034, Karnataka, India. Indian J Med Microbiol 2003;21:115-7A.

7.      Rao MKK, Nagendra A, Gupta RM, Ohri VC, Raghunath D. An epidemic of hepatitis E in army garrison, Gwalior. Indian J Med Microbiol 1998;14:197-200.

8.      Henry JB. Viral infections . Clinical diagnosis and management by laboratory methods. 20th editition, 1065.

9.      Laboratory manual of Armed Forces medical services , Vol 2,2009 special techniques , pg 414-415.

10.  Tandon BN. Viral hepatitis in tropics and its management. JAMA India - The physicians' Update 2001;4:102-6.   

Corresponding Author

Rigvardhan

Associate Professor, Dept of Pathology

Command Hospital (CC) Lucknow (UP) PIN- 226002

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